A Systematic Review of International Clinical Guidelines for Rehabilitation of People With Neurological Conditions: What Recommendations Are Made for Upper Limb Assessment?

Conclusions: We present a comprehensive, critical, and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers, and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.This review formed part of the COST Action TD 1006A European Network on Robotics for Neurorehabilitation. It was an interdisciplinary EU-funded research network concentrating on the coordination of European research in the area of rehabilitation robotics

Unidisciplinary CPD in a multidisciplinary world: Experiences from practice

Continuing professional development (CPD) has become relevant to all healthcare staff as professional bodies develop processes to revalidate and renew registration based on evidence of lifelong learning and CPD. As a result, the number of practice and professional development groups such as journal clubs, is increasing. Little evidence is available to differentiate between unidisciplinary and multidisciplinary CPD group activities, although by anecdotal reports, the number of unidisciplinary CPD groups appears to be growing. This study aimed to evaluate the value of a unidisciplinary occupational therapy CPD group to its six participants, the multidisciplinary teams in which they worked, and for the service users referred to them. A qualitative approach from a phenomenological perspective was used to explore this previously under-researched area. Triangulation of the data was achieved using postal questionnaires with open questions, the service manager as key informant and a research diary. Four main themes emerged from the inductive analysis: critical evaluation of practice to improve service delivery, improving communication for mutual learning, developing as a discipline with the multi-disciplinary team, and developing clinical skills. The implications of the study both for this uniprofessional group as well as for the multidisciplinary teams in which the occupational therapists worked are discussed, with recommendations made for future practice

An evaluation of a nurse led unit: an action research study

This study is an exemplar of working in a participatory way with members of the public and health and social care practitioners as co-researchers. A Nurse Consultant Older People working in a nurse-led bed, intermediate care facility in a community hospital acted as joint project lead with an academic researcher. From the outset, members of the public were part of a team of 16 individuals who agreed an evaluation focus and were involved in all stages of the research process from design through to dissemination. An extensive evaluation reflecting all these stakeholders’ preferences was undertaken. Methods included research and audit including: patient and carer satisfaction questionnaire surveys, individual interviews with patients, carers and staff, staff surveys, graffiti board, suggestion box, first impressions questionnaire, patient tracking and a bed census. A key aim of the study has been capacity building of the research team members which has also been evaluated. In terms of impact, the co-researchers have developed research skills and knowledge, grown in confidence, developed in ways that have impacted elsewhere in their lives, developed posters, presented at conferences and gained a better understanding of the NHS. The evaluation itself has provided useful information on the processes and outcomes of intermediate care on the ward which was used to further improve the service

Communication between therapists and nurses working in inpatient interprofessional teams: Systematic review and meta-ethnography

Purpose: The aim of the synthesis was to develop new understanding about the influences on communication in interprofessional teams from therapist and nurse perspectives. Methods: Six electronic databases were searched, combined with citation tracking and hand searching, yielding 3994 papers. Three researchers were involved in screening and quality appraisal, resulting in 18 papers for synthesis, using the process of meta-ethnography. Concepts were identified, compared and translated under five category headings. Two researchers mapped interpretative summaries and a line of argument was created. Results: The line of argument is that four inter-related contingences underpin effective communication between therapists and nurses. Effective communication depends on there being a genuine need to give and receive information for patient care, the capacity to attend to, hold, and use information, and opportunities to share space to enable communication to occur. The fourth contingency is good quality relationships and this is the glue that holds the contingencies together. Conclusion: This synthesis has provided an opportunity to illuminate how therapists and nurses accomplish interprofessional work through communication. The contingencies of need, capacity, opportunity and quality of relationships create a new structure for understanding what underpins communication between these two groups .Peer reviewedFinal Accepted Versio

Therapists’ experiences and perceptions of teamwork in neurological rehabilitation: Critical happenings in effective and ineffective teamwork

This article reports the second part of an exploratory study into occupational therapists` and physiotherapists` perceptions and experiences of team-work in neurological rehabilitation: the factors that were thought to influence effective and ineffective team-work, and the meaning behind effective and ineffective team work in neurological rehabilitation. The study was undertaken through semi-structured interviews of 10 therapists from three different neurological rehabilitation teams based in the United Kingdom, and used the critical incident technique. Through analysis of the data, several main themes emerged regarding the perceived critical happenings in effective and ineffective team work. These were: team events and characteristics, team members` characteristics, shared and collaborative working practices, communication, specific organisational structures, environmental, external, and patient and family related factors. Effective and ineffective team-work was perceived to impact on a number of levels: having implications for the team, the patient, individual team members, and the neurological rehabilitation service. The study supported the perceived value of team work within neurological rehabilitation. It also indicated the extensive and variable factors that may influence the team working process as well as the complex and diverse nature of the process

Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted